因服用非处方钙补充剂引起的可逆性脑血管收缩综合征（RCVS）。
Reversible cerebral vasoconstriction syndrome (RCVS) caused by over-the-counter calcium supplement ingestion.
机构信息
Department of Internal Medicine, Section on Pulmonary, Critical Care, Allergy and Immunological Diseases, Wake Forest Baptist Health, Winston-Salem, North Carolina, USA.
Department of Neurology, Section on Neurocritical Care, Wake Forest Baptist Health, Winston-Salem, North Carolina, USA.
出版信息
BMJ Case Rep. 2021 Jan 28;14(1):e233877. doi: 10.1136/bcr-2019-233877.
A 59-year-old woman was found unresponsive at home. Initial neurologic examination revealed aphasia and right-sided weakness. Laboratory results demonstrated a serum calcium level of 17.3 mg/dL (corrected serum calcium for albumin concentration was 16.8 mg/dL). Extensive workup for intrinsic aetiology of hypercalcemia was unrevealing. Further discussion with family members and investigation of the patient's home for over-the-counter medications and herbal supplements revealed chronic ingestion of calcium carbonate tablets. CT angiogram of the brain revealed multifocal intracranial vascular segmental narrowing, which resolved on a follow-up cerebral angiogram done 2 days later. These findings were consistent with reversible cerebral vasoconstriction syndrome.Appropriate blood pressure control with parenteral agents, calcium channel blockade with nimodipine and supportive care therapies resulted in significant improvement in neurologic status. By discharge, patient had near-complete resolution of neurologic symptoms.
一位 59 岁女性被发现在家中无意识。初步神经检查显示失语症和右侧无力。实验室结果显示血清钙水平为 17.3mg/dL（校正白蛋白浓度后的血清钙为 16.8mg/dL）。对高钙血症的内在病因进行了广泛的检查，但未发现异常。与家属进一步讨论并对患者家中的非处方药和草药补充剂进行调查，发现其长期服用碳酸钙片。脑部 CT 血管造影显示多发性颅内血管节段性狭窄，2 天后进行的随访脑血管造影显示狭窄缓解。这些发现与可逆性脑血管收缩综合征一致。通过给予静脉药物控制血压、使用尼莫地平进行钙通道阻断以及支持性护理治疗，患者的神经状态显著改善。出院时，患者的神经症状几乎完全缓解。
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